Goserelin (Zoladex ®)

Warning: Goserelin should not be given to a pregnant woman as it can
cause fetal harm. The medication is also associated with hypoestrogenism (reduced level of
estrogen) symptoms such as hot flashes (flushes), headaches, vaginal dryness, erectile dysfunction or change in libido, depression, sweating and change in breast size.
Although very rare, Goserelin can increase the risk for a stroke or heart attack in patients
with heart problems.

The drug
should be used cautiously in patient having risk factors for osteoporosis, chronic tobacco or alcohol use and
patients receiving drugs that affect bone density.

Indication: Goserelin is used mainly to
treat prostate cancer in men. It is also used in women for breast cancer and certain uterine disorders
(endometriosis). It is also used to thin the walls of the uterus to prepare it for a procedure that will stop
abnormal uterine bleeding.

This
treatment is comparable to a hormone that is naturally produced in the body (luteinizing hormone releasing
hormone). It is effective because it lowers the estrogen in women and the testosterone in men. Women should not
take the 10.8 milligram syringe.

Dosage:Goserelin is implanted in your body by
a medical professional. It slowly releases hormones into your body over weeks and months. It is usually inserted
into the abdomen, below the navel. There is no need to remove this implant because it is entirely absorbed over
a few weeks or months.

Your
doctor may prescribe you different methods of receiving this medication. The 3.6 milligram syringe may be
prescribed to inject once every four weeks. There is also a 10.8 milligram syringe that is injected once every
12 weeks.

During
the first couple of weeks of starting this treatment you may experience an increase in hormones and
testosterone. You may also feel the side effects more, such as increased pain and size in tumor. Women usually
stop having a period altogether after receiving Goserelin. If you are still experiencing a period after 2
months, consult your doctor.

Your
body will usually absorb all of the medicine, however, if you are experiencing side effects that are
uncomfortable and not getting any relief your doctor may want to take it out. Consult your doctor if you are
experiencing side effects.

Overdose: To prevent
serious complications, the medication should be taken exactly according to
the indications on the label. In fact, not only Goserelin, but taking any medication in the right dose is the
first step to better treatment. No fatal case of Goserelin overdose has been reported so far; however, as is the
case with any drug, an overdose of Goserelin can cause serious health problems. If you feel that you have been
given an overdose, contact your doctor immediately.

Missing dose:
Avoiding missing dose and taking the medication at right time are keys to get good results from any drug including
Goserelin. Therefore, keep all appointment with your doctor and lab technicians. If for some reasons you cannot be
present at the hospital for the treatment, contact your health care provider before the date schedule for the
injection.

Before taking this medication or any
tell your doctor of all of your medical history as well as your family’s history of: long-term alcohol use,
smoking, osteoporosis, heart problems, stroke, high cholesterol, urinary blockage (men), spinal cord problems
(men), and unusual abnormal vaginal bleeding (women).

Goserelin may
also affect heart health of some patients. It can cause a rapid
heartbeat, as well as make you feel dizzy and faint. Tell your doctor of all heart problems you have experienced
in the past, as this may not be the medication for you.

Pregnant
women should not take this medication as it may cause harm to an unborn baby.

smokingcigarette and drinking alcohol are strongly prohibited when being treated with Goserelin
.

Mechanism of action (MOA):
The hypothalamus uses LHRH (luteinizing hormone-releasing
hormone
) to transmit messages to thehypophysis
(also called pituitary gland), another gland in the brain. Having received the message, thehypophysis
command, by impulsion, to the ovaries in women and testes in men to produce the sex hormones estrogen (female
hormone) and testosterone (male hormone). Some forms of cancer cells need these hormones to survive and multiply.
Goserelin works by stopping the production of these hormones.

Interactions: Your doctor and pharmacist should know all of the
medication you are taking to avoid any possible interactions. Keep a list of all medications you are taking.
Some birth control methods (pill and patch) and medications that cause bone loss are known to interact with
Goserelin.

Tell your oncologist if you are taking or planing to
take vitamin supplements or St. John's wort.
Some medications can alter the effects of Goserelin, or increase the risk of side effects. Tell your doctor or
pharmacist if you are taking any of these medications:

testosterone
or androgens (men)

estrogen-containing birth control(women)

Medications
that promote loss of bone density, such as prednisone.

Side effects:
In addition to attacking cancer cells, Goserelin also affects healthy cells that multiply rapidly; this often cause
adverse effects in most patients. Most common Goserelin side effects include:

vision changes

constipation

hot
flashes

decreased sexual desire

weight
gain

headaches

bone pain

trouble sleeping

nausea or vomiting

pelvic
pain (women)

cessation of menstruation (women)

reduced volume of testes (male)

Swelling and tenderness of the
breasts

You should see your health care immediately if you experience any of these symptoms: